乌拉地尔和尼卡地平治疗高血压急症的比较

目的:比较乌拉地尔和尼卡地平治疗高血压急症的疗效和不良反应。方法:78例高血压急症病人分为乌拉地尔组和尼卡地平组,每组39例,乌拉地尔组先予12.5~25mg,iv,后以4μg·kg-1·min-1,iv,gtt,根据血压情况调整滴速,最大维持量12μg·kg-1·min-1。尼卡地平组先予2mg,iv,然后以1μg·kg-1·min-1,iv,gtt,根据血压变化调整滴速,最大维持量6μg·kg-1·min-1。记录用药前后血压、心率等指标的变化。结果:乌拉地尔和尼卡地平组显效、有效和无效分别为36,3,0例和34,4,1例,2组疗效无显著差异(P>0.05),但治疗后乌拉地尔组心率明显下降,尼卡地平组心率明显上升,两者比较差异非常显著(P<0.01);尼卡地平组治疗后最大降压效果出现时间明显迟于乌拉地尔组(P<0.01);心绞痛发作和脑出血加重人数多于乌拉地尔组;不良反应率也高于乌拉地尔组。结论:2种药物治疗高血压急症均效果良好,但乌拉地尔起效更快、应用更安全、适用范围更广。     

乌拉地尔和尼卡地平治疗高血压急症的疗效比较

摘要 目的比较乌拉地尔和尼卡地平治疗高血压急症的疗效和不良反应。方法 回顾性分析高血压急症患者44例,根据所用药物分为治疗组和对照组各22例。治疗组先给予乌拉地尔6.25～12.5 mg,iv,然后以2 μg·kg－1·min－1,静脉滴注,根据血压情况调整滴速,最大维持量6 μg·kg －1·min－1;对照组先给予尼卡地平1 mg,iv,然后以0.5 μg·kg－1·min－1静脉滴注,根据血压变化调整滴速,最大维持量3 μg·kg－1·min－1。记录用药前后血压、心率等指标。结果治疗组和对照组显效、有效和无效分别为18,4,0例和16,5,1例,两组疗效差异无统计学意义,但治疗组心率明显下降,对照组心率明显上升（P＜0.01）;对照组治疗后最大降压效果出现时间明显迟于治疗组（P＜0.01）,心绞痛发作和脑出血加重例数多于治疗组,不良反应发生率也高于治疗组。结论两种药物治疗高血压急症均效果均良好,但乌拉地尔起效更快,应用更安全,适用范围更广。     

乌拉地尔治疗高血压急症42例

高血压急症是常见的心血管病急诊之一,临床需要药物及时有效地降压处理,以减轻症状和防治并发症。近2年来,应用乌拉地尔注射液治疗42例高血压急症,现报道如下。1对象与方法1.1观察对象:本组42例,男26例,女16例,年龄28～79岁,平均(57.4±3.7)岁。全部病例均符合WHO和国际高血压学会(ISH)1999年制定的高血压诊断标准。本组合并高血压脑病17例,脑出血14例,急性左心衰6例,脑梗死3例,急性肾功能衰竭和妊娠高血压综合征各1例。1.2治疗方法:42例采用乌拉地尔注射液(商品名:“裕优定”,由华裕有限公司生产)25mg加入5 %葡萄糖液10ml静脉注射,继之…     

静注乌拉地尔治疗高血压急症21例

高血压急症不但对靶器官有损害,而且可危及患者生命,因此必须采取有效措施迅速降低血压。静脉注射乌拉地尔治疗高血压急症具有疗效确切、使用方便、副作用少等特点,现将我们初步应用结果总结如下。１病例及方法１．１病例选择半年来在我科住院的高血压急症患者２１例,其中男１６例,女５例,年龄平均４８岁(３７～６５岁),其中诊断为高血压性脑病５例,原发性高血压病６例,高血压危象６例,高血压合并脑梗塞４例;患者收缩压(ＳＢＰ)≥１８０ｍｍＨｇ和(或)舒张压(ＤＢＰ)≥１１０ｍｍＨｇ,参照有关高血压急症诊断标准［１］。其中入院前肌注利血…     

乌拉地尔与硝酸甘油治疗高血压急症的疗效比较

目的比较乌拉地尔与硝酸甘油用于高血压急症治疗的临床效果.方法选择我院2010年6月至2012年12月收治高血压急症患者共54例,按照随机数字表法将患者随机分为两组,治疗组和对照组。两组患者均给予吸氧、监测血压、休息等常规处理．对照组给予硝酸甘油静脉滴注,治疗组患者给予乌拉地尔治疗。治疗后30min评价两纽患者的治疗有效率和不良反应情况。结果治疗组患者治疗30min后,显效17例,有效9例,无效1例,有效率为96．3％;对照组显效10例,有效13例,无效4例,有效率为85．2％,两组有效率比较,差异有统计学意义（P〈0．05）。对照组治疗过程中出现血压过低、头晕、恶心等共有6例,发生率为222％;治疗组患者治疗过程中出现血压过低、头晕、恶心等共有4例,发生率为148％;两组比较差异无统计学意义（P〉0.05）。结论乌拉地尔用予高血压急症院前急救起效迅速,降压平稳,不良反应少,值得临床推广。     

乌拉地尔治疗高血压急症36例疗效观察

现将我院１９９８年２月～２００１年５月抢救３６例高血压急症患者的资料报道如下 :１资料及方法１ １临床资料 :３６例高血压急症患者 ,符合《１９９９ＷＨＯ／ＩＳＨ高血压治疗指南》中血压水平的定义和分类标准 ,其中男２３例 ,女１３例 ,年龄５２～７８岁 ,平均年龄６５岁 ,高血压危象１４例 ,高血压脑病１７例 ,恶性高血压５例 ,血压２１０～３００／１００～１４０ｍｍＨｇ。１ ２方法 :患者入院后给心电图监护 ,在内科综合治疗基础上立即使用德国ＢＹＫＧＵＬＤ药厂生产的乌拉地尔针２５ｍｇ加入５ %葡萄糖液４０ｍｌ中静脉推注 ,要…     

乌拉地尔治疗高血压急症62例

目的;观察乌拉地尔治疗高血压急症的临床疗效.方法;62例高血压急症患者,给予乌拉地尔12.5～25.0 mg加入5%葡萄糖注射液20 mL静脉推注,观察用药前,用药后即刻,5,10,30,60,120 min收缩压(SBP)、舒张压(DBP)、心率(HR)的变化,合并靶器官症状的恢复以及不良反应.结果;显效59例(95.2%),有效61例(98.4%),大多数患者在用药后即刻血压已开始下降,10～30 min下降达最大值,此后相对稳定.SBP、DBP用药后各时间段与用药前比较下降显著,靶器官症状的恢复快,不良反应小.结论;静脉注射乌拉地尔降压迅速、平稳、安全,不增高颅内压、不增快心率,不良反应小,可作为治疗高血压急症的首选药物.     

乌拉地尔治疗高血压急症疗效分析

我院于2001年3月-2004年5月期间应用乌拉地尔治疗高血压急症43例取得较好疗效，现报道如下：     

乌拉地尔治疗高血压急症34例临床疗效分析

目的探讨乌拉地尔治疗高血压急症的临床疗效。方法选择泗洪县人民医院34例高血压急症患者,根据患者临床情况,给予乌拉地尔注射液治疗。观察用药后5、10、20、30、60、90min的收缩压、舒张压以及心率。结果用药后5、10、20、30、60、90min的收缩压、舒张压与用药前比较,差异有统计学意义(P<0.01);而心率与治疗前相比,差异无统计学意义(P>0.05)。结论乌拉地尔治疗高血压急症临床疗效显著,乌拉地尔可以在短时间控制血压,值得临床借鉴。     

乌拉地尔治疗高血压急症40例疗效观察

目的探讨乌拉地尔治疗高血压急症的疗效。方法对符合高血压急症诊断的患者40例,给予乌拉地尔50mg加入生理盐水至50ml。持续静脉微泵滴入,分别记录30min,1h、3h、6h、9h、12h、18h、24h血压和心率水平。结果治疗后0．5h的SBP、DBP、HR与治疗前相比．明显降低。结论静脉注射乌拉地尔治疗高血压急症起效快,显效率高,使用安全,无明显副作用,可作为高血压急症的一线药物。     

苯那普利对慢性肾衰合并肾性高血压患者的治疗作用与血浆神经肽Y相关性分析

目的 :探讨慢性肾衰 (CRF)合并肾性高血压患者使用苯那普利治疗前后血压、肾功能、血浆神经肽Y(NPY)含量的变化及其相关性。方法 :CRF合并肾性高血压患者 3 0例 ,使用苯那普利治疗前及用药 4wk后分别测定收缩压 (SBP)、舒张压 (DBP)、血肌酐 (Scr)、血浆NPY ;另采用本院核医学科血浆NPY正常值作对照。结果 :治疗前后血浆NPY水平均高于正常 (P <0 .0 1 )。治疗后与治疗前相比 ,NPY降低明显 (P <0 .0 1 ) ,SBP、DBP及Scr明显下降 (P<0 .0 1 ) ,且血浆NPY与SBP下降有显著相关性 (r=0 .67,P <0 .0 1 )、与DBP、Scr下降关系不明显 (P>0 .0 5 )。结论 :CRF合并肾性高血压患者使用苯那普利治疗后 ,血浆NPY、血压下降 ,肾功能改善     

Acute haemodynamic effects of urapidil in patients with chronic left ventricular failure

Summary Urapidil, a new alpha₁-adrenoceptor blocking drug, has been shown to be effective in the treatment of hypertension. Ten normotensive patients with severe congestive heart failure were given Urapidil 25 mg i.v. twice in 15 min and the haemodynamic effects were measured.There was a significant fall in systolic blood pressure (–16%), mean blood pressure (–13%), left ventricular end-diastolic pressure (–38%), mean pulmonary artery pressure (–31%) and wedge pressure (–40%). Total peripheral resistance fell by 25%, whereas pulmonary arteriolar resistance did not change significantly. Cardiac output increased by 22%.The increase in cardiac output with decreasing peripheral resistance and LV pressures suggests that urapidil may be useful in the therapy of congestive heart failure.     

卡维地洛对慢性心衰合并肾功能不全患者肾功能的影响

目的:评价卡维地洛对慢性心衰(CHF)合并慢性肾功能不全(CRF)患者肾功能的影响。方法:入选27例CHF合并CRF患者,在充分抗心力衰竭治疗的基础上,加用卡维地洛,观察不同阶段左室射血分数(LVEF)和肾功能的变化。结果:卡维地洛治疗后,LVEF在治疗3个月后开始升高,12个月后显著高于基线水平(p<0.01)。治疗后1个月,血肌酐(Scr)升高(p<0.05),3个月时回落到基线水平以下(p<0.05),12个月时仍低于基线水平(p<0.05);治疗后1个月,内生肌酐清除率(Ccr)先轻度下降(p<0.05),3个月时回升高于基线水平(p<0.01),12个月时仍显著高于基线水平(p<0.01)。卡维地洛对尿微量白蛋白和24h尿蛋白定量影响不大(p>0.05)。结论:第三代β-受体阻滞剂卡维地洛,可改善慢性心衰合并慢性肾功能不全患者的心功能,早期引起肾功能的轻度降低,随后肾功能显著改善。     

Pharmacokinetics of quinine in patients with chronic renal failure

Methods: We investigated the pharmacokinetics of quinine (Qn) following administration of a single oral dose of 600 mg Qn sulphate in six male Thai patients with a moderate degree of chronic renal failure (CRF), and six male Thai subjects with normal renal function. Results: The drug was well tolerated in both groups of subjects; no major adverse reactions were observed. A marked alteration in the pharmacokinetics of Qn was found in patients with CRF compared to healthy subjects; there were six signifiicant changes in the pharmacokinetic parameters. Absorption was delayed, but increased in CRF (t_max 4.5 vs 1.6 h, C_max 6.17 vs 3.45 g·ml^–1). Total clearance was significantly reduced 0.94 vs 2.84 ml·min^–1·kg^–1, whereas V_z/f remained unchanged (1.82 vs 2.78 1·kg^–1). This resulted in the increased values of AUC and prolongation of the t_1/2z and MRT in the patients (AUC 181.5 vs 61.8 g·min^–1·ml^–1, t_1/2z 26 vs 9.7 h, MRT 36.4 vs 11.3 h). Median concentrations of plasma unbound fraction of Qn collected at 4 h after drug administration in patients and healthy subjects were 7.3 vs 9.8%, respectively.     

The acute haemodynamic effects of nicardipine in patients with chronic left ventricular failure

Summary Nicardipine is a new slow channel calcium blocker. It has been shown to be effective in the treatment of hypertension and angina pectoris. Nine patients with mild to moderate left ventricular failure were given intravenous infusions of nicardipine and the haemodynamic effects measured. In patients receiving 20 mg of nicardipine, mean cardiac index rose to a peak 1.8 l·min^–1·m^–2 (64%) above the preinfusion level, stroke volume index rose by 12 ml·m^–2 (35%) and heart rate rose by 16 beats·min^–1 (20%). There was a significant fall in systemic vascular resistance of 50% manifested by a reduction of 22 mm Hg in systolic blood pressure (18%) and 18 mm Hg in diastolic blood pressure (22%). Pulmonary vascular resistance fell by 45%. Mean pulmonary artery pressure and capillary wedge pressure did not change significantly. This study suggests that concomitant mild to moderate left ventricular failure is not a contra-indication to nicardipine therapy in patients with angina.     

Pharmacodynamics and pharmacokinetics of three different doses of urapidil infused in hypertensive patients

Summary The study was designed to follow the haemodynamic effects and pharmacokinetics under steady-state conditions of three different doses of urapidil infused continuously. Nine male hypertensive patients received three randomly assigned intravenous infusions of 32.5, 65 and 130 mg urapidil, over 14 h during 6 consecutive days, in a change-over fashion. Blood pressure and heart rate were measured over a period of 28 h after the infusion began and were compared with a reference profile obtained prior to the treatment periods. Urapidil and its main metabolite, parahydroxylated urapidil, were also determined for 28 h after the infusion began using HPLC. The 32.5 mg dose of urapidil caused a maximum decrease in systolic blood pressure of 33±8 mmHg, the 65 mg dose a maximum decrease of 39±12 mmHg and the 130 mg dose a maximum decrease of 50±12 mmHg. The 32.5 and 65 mg doses resulted in similar serum urapidil concentrations, with maximum levels in the 100 to 200 ng/ml range, and the 130 mg dose caused a maximum level approximately four times that achieved with the 32.5 mg dose. The serum concentration of parahydroxy urapidil was proportional to the corresponding dose of urapidil. Four patients reported mild headache, fatigue, weakness, pressure in the head, perspiration and orthostatic dysregulation. The side-effects were probably drug related but required no specific therapy. In summary, the 32.5 mg dose of urapidil resulted in a pronounced decrease in blood pressure. The average pressure reduction over the 14-h infusion period showed further dose-dependent increases after the 65 and 130 mg doses. In severe hypertension, the 130 mg dose can be employed, since it does result in a further, significantly larger decrease in blood pressure.     

Lisinopril in hypertensive patients with and without renal failure

Summary Lisinopril (MK521), a lysine analogue of enalaprilic acid, the bioactive metabolite of enalapril, has a longer half-life than enalaprilic acid, and is excreted unchanged in the urine. Its kinetic profile and antihypertensive and hormonal effects have been investigated in an open study in 3 groups each of 6 hypertensive patients, with normal, moderate and severe impairment of renal function. Serum drug level, blood pressure, converting enzyme activity (CEA), plasma renin activity (PRA), aldosterone concentration (PAC), and serum potassium and creatinine were measured during 1 week following a single oral dose and subsequently following 8 daily doses of 5 mg lisinopril. Accumulation of lisinopril was found in the severe renal failure group. CEA was suppressed to less than 10% of its initial value from 4 to 24 h after the initial dose in all three groups, and the suppression was more marked and lasted longer in patients with severe renal failure. An inverse correlation was found in all patients between log serum lisinopril concentration and log CEA. Lisinopril lowered blood pressure in all three groups over 24 h. PRA rose and PAC fell similarly in the groups. Serum potassium increased in the renal failure groups and creatinine remained unchanged in all groups.Thus, when lisinopril 5 mg is given daily to patients with severe renal failure it may accumulate. The high serum lisinopril concentration does not cause an excessive antihypertensive effect. In patients with severe renal failure, adjustment of the dose or the dosing frequency to the degree of renal failure is recommended to avoid administration of doses in excess of those required to achieve adequate inhibition of converting enzyme.     

伴有重度肾功能不全的慢性肾小球肾炎患者可以应用依那普利吗？

目的 探讨依那普利对伴有重度肾功能不全的慢性肾小球肾炎患者的有效性和安全性.方法慢性肾小球肾炎患者46例,以内生肌酐清除率(Ccr)分为两组.高Ccr组Ccr 50 ml·min-1以上,13例;中Ccr组Ccr 25～50 ml·min-1,17例;低Ccr组Ccr 25 ml·     

左卡尼汀联合前列地尔对慢性肾功能衰竭患者合并心功能衰竭的临床疗效

目的 探讨左卡尼汀联合前列地尔对慢性肾功能衰竭患者合并心功能衰竭的临床疗效。方法 选取80例慢性肾功能衰竭合并心功能衰竭患者,随机分为两组,对照组（39例）给予前列地尔治疗,观察组（41例）给予左卡尼汀联合前列地尔治疗,观察并记录两组治疗前后心功能系数、肾功能指标、SF-36量表评分及治疗期间不良反应情况,评价左卡尼汀联合前列地尔对慢性肾功能衰竭合并心功能衰竭患者的临床疗效。结果 治疗前,两组心输出量（CO）、心脏指数（CI）、心肌耗氧量（MVO）、射血分数（EF）水平相比,差异无统计学意义;治疗后,两组CO、CI、MVO水平均降低且观察组上述指标值更低（P＜0.05）;治疗后观察组EF值明显增加且高于对照组（P＜0.05）,对照组EF值与治疗前相比无明显改变。治疗前两组胱抑素C（CysC）、血尿素氮（BUN）、血肌酐（SCr）水平相比,差异无统计学意义;治疗后,两组CysC、BUN、SCr水平均降低且观察组上述指标值更低（P＜0.05）。治疗前,两组SF-36量表各项评分相比,差异无统计学意义;治疗后观察组在生理功能、生理职能、总体健康上的评分均明显高于对照组（P＜0.05）,其余各项评分相比差异无统计学意义。治疗期间,两组不良反应率差异无统计学意义。结论 左卡尼汀联合前列地尔对慢性肾功能衰竭合并心功能衰竭具有较好的疗效,能明显改善患者心功能,降低心脏负荷;改善肾功能,增加肾小球滤过率;进而改善患者生活质量,联合用药具有安全性,值得临床推广使用。